NHS Payment Scheme
The NHS Payment Scheme (NHSPS) contains rules to establish the amount payable for NHS-funded secondary healthcare.
2023/25 NHSPS came into effect on 1 April 2023. Following consultation, some amendments have been made for 2024/25. The 2023/25 NHSPS (amended) came into effect on 1 April 2024.
The consultation on proposals for the 2025/26 NHS Payment Scheme runs until midnight at the end of 28 February 2025.
Contents
- Consultation on the 2025/26 NHS Payment Scheme
- About the NHS Payment Scheme
- Keep informed about payment system development
- Applying for variations
- Nominating changes for the high cost drugs and devices lists
- Join our FutureNHS workspace
- Access to past national tariffs
Consultation on the 2025/26 NHS Payment Scheme
The consultation on proposals for the 2025/26 NHS Payment Scheme runs until midnight at the end of 28 February 2025.
All responses must be submitted via the online survey. A Word version of the survey is provided in the supporting documents to help compile responses.
Please contact england.pricingenquiries@nhs.net for more information.
About the NHS Payment Scheme
The 2023/25 NHSPS has been set for two years (2023/24 and 2024/25). It contains rules for four payment mechanisms:
- Aligned payment and incentive (API) – covers almost all NHS provider activity and comprises fixed and variable elements. Almost all elective activity, and all activity which form part of the ERF, is included in the variable element and paid for using 100% of NHSPS unit prices.
- Low volume activity (LVA) block payments – applies to almost all NHS provider/commissioner relationships with an annual value below £0.5m. Commissioners should pay providers the nationally set LVA value, based on a three-year rolling average, with no other transactions in-year.
- Activity-based payment – applies to all services with NHSPS unit prices delivered by non-NHS providers. Activity is paid for using 100% of NHSPS unit prices for each unit of activity delivered.
- Local payment arrangements – providers and commissioners locally agree an appropriate payment approach.
The NHSPS includes unit and guide prices (published in Annex A), calculated using largely the same method as National Tariff prices (for detail, see Annex D).
Following consultation, some amendments to the Payment Scheme have been made for 2024/25. The prices and LVA values have also been updated to reflect the 2024/25 cost uplift and efficiency factors, but these were not subject to further consultation.
If you have any questions about the NHS Payment Scheme, please contact england.pricingenquiries@nhs.net.
Related resources
- Prescribed specialised services (PSS) manual
- Operational planning and contracting guidance
- 2023/24 NHS Standard Contract
Keep informed about payment system developments
For more information about payment developments, please join the Payment system support FutureNHS workspace. We will also contact workspace members with updates and engagement opportunities. Contact england.pricingenquiries@nhs.net for more information.
Applying for variations
Providers and commissioners can apply for variations to the NHSPS. All applications should use the variations request template and need to be approved by the relevant NHS England regional team(s) before submission to the NHS England national team. Completed and approved templates should be sent to england.pricingenquiries@nhs.net.
Nominating changes to the high cost drugs and devices lists
Within the NHS Payment Scheme, some high cost drugs and devices are excluded from the calculation of unit prices and national prices. Funding for these items is then either included in a fixed payment or paid for in addition to the price for the related service. As medical practice changes and new drugs and devices are developed and adopted, the lists of high cost drugs and devices needs to be kept as current as practically possible.
To nominate a drug or device to be added or removed from the high cost lists, please complete the following form and submit it to england.pricingenquiries@nhs.net.
Nominations must be submitted by the end of May before the subsequent year’s Payment Scheme (ie, for nominations to be considered for 2026/27, the completed form needs to be submitted by 31 May 2025). We cannot guarantee that submissions received after that date will be considered until the following year. All submissions received before the deadline will be carefully reviewed and discussed with high cost steering groups.
Join our FutureNHS workspace
Our Payment system support workspace on the FutureNHS collaboration platform contains materials, tools and products being developed to support people to implement the payment system.
Currently launched on the workspace include:
- ICS Cost Benchmarking Dashboard – a dashboard showing cost and activity data for a whole system, at an ICS level. It allows systems to identify service level spend and patient pathway patterns.
- Costed pathways (supported by GIRFT) – a methodology and worked example for systems to cost patient pathways, highlighting variation from clinical best practice guidelines in activity and costs.
We welcome your feedback on these products, and will continue to develop and update them based on the comments we receive.
Please contact england.pricingenquiries@nhs.net if you have any questions.
Access to past NHS Payment Schemes and national tariffs
The NHS Payment Scheme replaced the National Tariff Payment System. You can download all formal documents and policies from previous years.
Please contact england.pricingenquiries@nhs.net if you need any more information.